Category Archives: Psychotherapy

A Self-Help Gem—Creating Space Between Stimulus and Response

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Our behavior is driven by unconscious urges. We roll through our days like robots, our actions largely determined by stimulus-response chains.

*****

I see a photo of a large café mocha made with whole milk and dark chocolate, topped with mounds of whipped cream (stimulus). I feel a desire that starts in my gut and practically makes me drool (response).

The urge to act on that desire—before I even know what’s going on inside me—is strong.

If I do give in, the cost is five dollars, 500 calories, and God knows how much saturated fat.

*****

I’m walking through an intersection and almost get hit by a driver who’s speeding and runs a red light (stimulus).

I retreat to the curb and feel an urge to scream at the driver (response).

Acting on that urge won’t change the driver’s behavior, of course. But it will raise my blood pressure, strain my voice, and infect me with an emotional negativity that lingers for hours.

*****

This all seems so mind-numbingly obvious once I stop to see it. Yet I seldom do that.

This is the way my life unfolds—existing on a sub-human level, moving through a waking sleep.

No wonder that Gurdjieff described us as “machines among machines.”

There is another option—To become aware. To live like a conscious human being.

To wake up.

*****

The key is putting a space between stimulus and response. This is a major theme in the literature of self-help, spiritual practice, and psychotherapy.

Recently I found a particularly useful expression of this idea in Inquiring Mind, a Buddhist journal. It is an interview conducted by Kevin Griffin, author of One Breath at a Time: Buddhism and the Twelve Steps.

Griffin spoke with Alan Marlatt, director of the Addictive Behaviors Research Center at the University of Washington. Marlatt developed the Mindfulness-Based Relapse Prevention (MBRP) program. Its purpose is to help recovering alcoholics and addicts learn not to act on urges to drink alcohol or use other drugs.

The essence of MBRP is meta-cognition. Marlatt describes this as “the ability to stand back, observe what is happening and think about what you are doing rather than being on automatic pilot.”

Marlatt goes on to explain a handy technique for meta-cognition. He summarizes the steps in this technique with an acronym—SOBER.

Suppose that you’re a recovering alcoholic and you walk by a bar you used to visit. A thought arises: I could just step inside and see if anyone I know is there.

That thought is a stimulus, triggering a craving for alcohol. And a likely response is falling off the wagon.

Instead, you can:

  • Stop walking.
  • Observe your thoughts and feelings.
  • Breathe will mindful awareness.
  • Expand your awareness so that you can visualize the likely result of entering the bar.
  • Respond in a way that sustains your recovery—such as walking quickly away from the bar.

This is a simple and practical way to deal with cravings of any type. The essence is to stop, breathe, and cultivate a moment of self-awareness.

That’s all it takes to introduce a sacred space between stimulus and response.

Like the old saying goes: What you are aware of, you can control; what you are not aware of, controls you.

Image by hmerinomx, Flickr Creative Commons

Does Behavior Change Gradually or Immediately?

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I just finished listening to a marvelous audiobook by psychotherapist Bruce Tift from Sounds True—Already Free: Buddhism Meets Psychotherapy on the Path of Liberation. One thing that I appreciate about Tift is his “big sky mind”—his willingness to see contradictory ideas from a wider perspective that embraces all of them.

Case in point: Buddhism and psychotherapy.

Both Buddhism and psychotherapy aim to help us stop suffering. And, they propose different means to get there.

“Buddhist practice helps us awaken to a well-being that is independent of our circumstances,” Tift says, “while Western psychotherapy helps us bring our disowned experience into awareness in order to live in a more skillful and satisfying way.”

Two Paths to Change

Put another way, Buddhist practice changes us by helping us see things as they are in this moment—without the filters imposed by our concepts and judgments. We can call this the immediate path.

Psychotherapy, too, is about seeing things as they are. But therapy takes place in stages. We accumulate insights. We clarify intentions. We plan new behaviors and perhaps change our circumstances. This valuable process takes place over time. Call it the gradual path.

So which do we choose? Immediate or gradual?

Tift’s answer—both.

“These two approaches sometimes contradict and sometimes support each other,” Tift explains. “When used together, they can help us open to all of life in all its richness, its disturbances, and its inherent completeness.”

More About the Immediate Path

In Western cultures, most of us are familiar with the gradual path. It fits with our conventional ideas about setting goals and taking action to achieve them. So, l’d like to describe the immediate path in more detail.

When taking this path, we see that effortless action flows from clear seeing. Awareness itself brings change. Doing flows from being—the way we see things before we take any action.

When we see the world without the distortions imposed by attachment and aversion, our behavior changes naturally. We can find many examples of this:

When we stop seeing people as enemies, we treat them kindly.

When we see that a personal habit inevitably makes us suffer, we’re free to drop it.

Simply by noticing that you’re slumping in your chair, you naturally assume a posture that is both more erect and more comfortable.

During meditation, simply noticing points of tension in your body allows you to relax.

Embracing Both Paths

So when you’re faced with a behavior that you want to change, Tift says, you always have two options.

One option is the gradual path. Take the time to learn new skills, one at a time, and practice them until they become habits. List the steps needed to achieve a goal and complete those steps one at a time.

Make the effort and welcome the change. It works.

Another option is the immediate path. Instead of planning to change the behavior, just shine the light of awareness on it and notice what happens.

Make no effort and welcome the change. It works.

Isn’t it great that we get to live with paradox?

‘Taming Your Gremlin’—Revisiting a Self-Help Classic

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Rick Carson’s Taming Your Gremlin: A Guide to Enjoying Yourself begins by announcing its modest aim:

This book is not intended to guide you to enlightenment, to eternal bliss, or to riches. It will, however, help you enjoy yourself more and more each day.

What a refreshing sentiment in this age of books that promise quick fixes and instant nirvana! Moreover, Carson actually delivers on his promise with a little gem of a book that you can read in one sitting.

Rick Carson is a psychotherapist, executive coach, and trainer who works with mental health professionals, businesses, and nonprofit organizations. He is a former faculty member at the University of Texas Southwestern Medical School and an approved supervisor for the American Association for Marriage and Family Therapy.

Our Baseline—Pure Enjoyment

Carson’s premise is that we enter this world as beings who are capable of constant enjoyment. Yet by the time we become adults, this innate capacity is long forgotten.

How does this happen?

Enter your gremlin.

Recognize the Gremlin

Carson defines your gremlin as “the narrator inside your head.” This is the constant stream of thinking that interprets your experience and evaluates each event in your life.

The problem is that the gremlin is 1) constantly active 2) highly critical and 3) committed to making you believe that his interpretations are absolutely true.

According to Carson, your gremlin is happiest when you worry about the future, rehash events from the past, dwell on failures, and analyze other people’s faults.

Of course, the gremlin is simply a metaphor for the systems of irrational beliefs that Albert Ellis and other cognitive psychologists have explored in such detail.

Carson’s gift is suggesting that we visualize those belief systems as pesky little demons that live inside our head. Holding this image allows us to detach from our irrational beliefs—and eventually free ourselves of them.

Get to Know a Few Gremlins

One delight of reading Carson’s book is seeing its comic illustrations of various gremlins and reading their colorful descriptions. For example:

Katherine is 40. Her gremlin looks like her grandfather only he engages her by preaching to her from the New Testament. He especially likes to make appearances when Katherine is having sex with someone. Until Katherine began to tame her gremlin, she was not only good and righteous, but lonely, emotionally isolated, and unable to have an orgasm.

While everyone’s gremlin is unique, he is not original. In fact, gremlins tend to hammer on some core messages. For example:

Your true self is unlovable.

You can only enjoy yourself for short periods of time.

Fast is good and slow is bad.

To show sadness is to be weak or childish or unreliable or overly dependent.

Nice girls don’t enjoy sex.

Nice girls certainly don’t show that they enjoy sex.

Asking for what you want is selfish.

To show anger is to be sinful, childish, unprofessional, and/or out of control.

To express uncensored joy is to be silly or unprofessional.

Not acknowledging and/or not expressing feelings will make them go away.

How Your Gremlin Wins

Our natural response to a gremlin is to argue with him—to deny, resist, and refute our irrational beliefs.

According to Carson, this attempt is doomed to failure.

Why? Because the gremlin thrives on attention and opposition. He is also a master debater. The moment that you engage with him in intellectual battle is the very moment that he wins—and you lose.

How to Tame Your Gremlin

The alternative to arguing with your gremlin is simple (though not easy). It is to simply notice the gremlin at work. Awareness of the gremlin—not thinking or arguing—is your most powerful response.

Carson reminds us that:

…as you begin to simply notice your gremlin, you will become acutely sensitive to the fact that you are not your gremlin, but rather his observer. You will see clearly that your gremlin has no real hold you. As this awareness develops, you will begin to enjoy yourself more an more. It is to you, the observer, that this book is written.

Here Carson aligns with the newer schools of cognitive behavioral therapy, such as Acceptance and Commitment Therapy. With these approaches, clients learn to greet their irrational beliefs with mindful attention rather than refute those beliefs and replace them with more rational alternatives.

In brief, Carson writes: “I change not by trying to be something other than I am. I change by being fully aware of how I am.”

Playing With Options

One of the most refreshing aspects of Taming Your Gremlin is Carson’s approach to behavior change. He believes that forcing ourselves to adopt a new belief or change a habit merely creates a new gremlin.

Instead, we can choose a new behavior in any moment. We can change for today rather than worrying about changing forever. We can play with change and experiment with options.

“So long as you are willing to ground yourself and simply notice, you will never lose the vantage point of the current moment, and from this home base of operation you can always choose to tame your gremlin,” Carson writes. Every moment holds the potential for compete self-enjoyment and for complete misery. The choice is yours.”

Three Beliefs That Make Us Miserable

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Albert Ellis created Rational Emotive Behavior Therapy (REBT), which is based on a single idea—it’s not events or other people that upset us; it’s what we think about those events and people.

Ellis liked to challenge, cajole, argue, prod, and poke holes in clients’ thinking. He was blunt, argumentative, and fond of four-letter words. But Ellis never attacked his clients personally. He just attacked their irrational beliefs. He continually asked clients: What are telling yourself to make yourself miserable?

Ellis published many books. Nearly all of them contained lists of irrational beliefs, along with his scathing (and often funny) rebuttals of them. Late in his life, however, he condensed his list of core irrational beliefs to just three:*

  • “I absolutely MUST, under practically all conditions and at all times, perform well (or outstandingly well) and win the approval (or complete love) of significant others. If I fail in these important—and sacred—respects, that is awful and I am a bad, incompetent, unworthy person, who will probably always fail and deserves to suffer.
  • “Other people with whom I relate or associate, absolutely MUST, under practically all conditions and at all times, treat me nicely, considerately and fairly. Otherwise, it is terrible and they are rotten, bad, unworthy people who will always treat me badly and do not deserve a good life and should be severely punished for acting so abominably to me.
  • “The conditions under which I live absolutely MUST, at practically all times, be favorable, safe, hassle-free, and quickly and easily enjoyable, and if they are not that way it’s awful and horrible and I can’t bear it. I can’t ever enjoy myself at all. My life is impossible and hardly worth living.”

Stated so baldly, these ideas sound ridiculous. But the next time you feel upset, monitor your own thinking. See if you can detect any rigid, extreme, or downright nonsensical beliefs.

Image by r0bm867, Flickr Creative Commons

*Albert Ellis (2003), Early theories and practices of rational emotive behavior theory and how they have been augmented and revised during the last three decades. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21(3/4): 219-243.

Three Ways to Deal With Disturbing Thoughts

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Recently I saw a bumper sticker: “Don’t Believe Everything You Think.” I’ve been thinking about it ever since.

We can classify schools of psychotherapy based on their ways of dealing with the thoughts that fuel depression, anxiety, and other mental health challenges.

Some major options are the “three D’s”—dispute, defuse, and distract.

1. DISPUTE

Albert Ellis—godfather of Rational Emotive Behavior Therapy (REBT)—was the first to champion this option. He prodded clients to bare their unconscious irrational beliefs and rigorously dispute them.

According to Ellis, the three beliefs responsible for most human suffering are:

  • I must always be perfectly competent.
  • Other people must always behave exactly the way that I expect.
  • Events must always turn out exactly the way I expect.

Since these statements all include the word must, Ellis also referred to them as examples of musterbating.

2. DEFUSE

REBT was an early form of cognitive therapy. More recent forms put much less emphasis on disputing irrational thoughts. The rationale is that “what we resist, persists.” That is, arguing with such thoughts focuses our attention on them and might actually reinforce them in a perverse way.

Acceptance and Commitment Therapy, Dialectical Behavior Therapy, and similar approaches recommend that we defuse instead. This is the opposite of fusing with thoughts—identifying with them and assuming that they are true.

Defusion means stepping back from our stream of thoughts and simply observing them. We see them as spontaneous mental events that occur without conscious intention.

Thoughts arise and pass, like clouds drifting across the sky. We watch them float by, focus on those serve us, and let go of the rest. This approach draws heavily on mindfulness meditation.

3. DISTRACT

Years ago I wrote a book about caregiving (alas, now out of print) with two other men. One of them was living with AIDS. He and his partner spent so much time dealing with the disease that they literally wore the topic out.

At one point they chose to basically stop talking about it.

“Is that denial?” I asked.

“No,” they said. “We’re 100 percent honest about AIDS. It’s impossible to ignore. We’re doing everything that we can to treat it. Beyond that, why dwell on it? We prefer conscious distraction.”

Well said.

Image by h.koppdelaney, Flickr Creative Commons